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The study included 26 patients with anterior or lateral defects occurring between 2018 and 2024, covering planned iatrogenic and accidental intraoperative injuries. All patients received multilayered repair with tailored perioperative management including selective lumbar drainage. Reconstructions were successful with no secondary failures and no postoperative meningitis or recurrent CSF leaks, though rare major complications included pneumocephalus and postoperative vision loss.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/skull-base-defects-outcomes-and-reconstruction-from-a-tertiary-center-in-india/448324/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/skull-base-defects-outcomes-and-reconstruction-from-a-tertiary-center-in-india/448324.png","ImageObject",300,407,{"name":92,"@type":93},"Aurelia","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What types of skull base defects were included in the study?","Question",{"text":112,"@type":113},"The study included anterior and lateral skull base defects arising from both planned iatrogenic injuries and accidental intraoperative defects.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were the skull base defects reconstructed?",{"text":117,"@type":113},"All patients underwent multilayered repair using combinations of autologous tissue, allogenic grafts, and vascularized flaps, with perioperative protocols including selective lumbar drainage when needed.",{"name":119,"@type":110,"acceptedAnswer":120},"What postoperative complications were observed?",{"text":121,"@type":113},"No postoperative meningitis or recurrent CSF leaks were noted. Two major complications occurred: one case of pneumocephalus and one case of postoperative vision loss after ossifying fibroma excision.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},448324,1790796672,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},1099514068365,"https://ap-avatar.wpscdn.com/avatar/10000253d8d9f28188e?_k=1776742907772140068","Archives of Craniofacial Surgery  \nArch Craniofac Surg Vol.26 No.6, 225-234 [https://doi.org/10.7181/acfs.2025.0036](https://doi.org/10.7181/acfs.2025.0036)  \nSkull base defects: outcomes and reconstruction from a tertiary center in India  \nPalak Gupta*, Srinivas Chadaram, Vidhu Sharma, Kapil Soni, Bikram Choudhury, Amit Goyal  \nDepartment of Otorhinolaryngology (ENT), All India Institute of Medical Sciences, Jodhpur, India  \nBackground: Skull base defects, accidental or planned during tumor resections, present significant reconstructive challenges. Effective repair prevents cerebrospinal fluid (CSF) leaks, meningitis, and pneumocephalus.  \nMethods: This retrospective observational study analyzed 26 patients with anterior or lateral skull base defects treated between 2018 and 2024 at a tertiary care center in Western India. Both planned iatrogenic and accidental intraoperative defects were included. Patient demographics, surgical approach, defect characteristics, reconstruction techniques, and postoperative outcomes were recorded. All patients underwent multilayered repair with tailored perioperative management, including selective lumbar drainage.  \nResults: Among 26 patients, 14 (53 .8%) had anterior and 12 (46 .2%) had lateral skull base defects. Intraoperative CSF leak occurred in 11 patients (42 .3%) . Defects were repaired using combinations of autologous tissue (fat, fascia lata, muscle), allogenic grafts (DuraGen), and vascularized flaps. Seven patients (26 .9%) required lumbar drains. All reconstructions were successful with no secondary failures. However, two major complications were observed: one case of pneumocephalus and one of postoperative vision loss following ossifying fibroma excision. No postoperative meningitis or recurrent CSF leaks were noted.  \nConclusion: Meticulous multilayered repair strategies and structured perioperative protocols provide excellent outcomes in skull base defect reconstruction. Differentiating between planned and accidental iatrogenic defects allows for better preoperative planning and individualized management. Despite a 100% repair success rate, rare but serious complications such as vision loss highlight the need for careful surgical technique near critical neurovascular structures.  \nAbbreviations: BMI, body mass index; CSF, cerebrospinal fluid; CT, computed tomography; MRI, magnetic resonance imaging; POD, postoperative day  \nKeywords: Cerebrospinal fluid leak / Endoscopy / Iatrogenic disease / Reconstructive surgical procedures / Skull base  \nINTRODUCTION  \nSkull base defects may arise from traumatic and atraumatic  \nCorrespondence: Vidhu Sharma  \nDepartment of Otorhinolaryngology (ENT), All India Institute of Medical Sciences, AIIMS Jodhpur, Marudhar Industrial Area, Basni, Jodhpur, Rajasthan 342005, India  \n[E-mail: vidhusharma88@gmail.com](E-mail: vidhusharma88@gmail.com)  \nHow to cite this article:  \nGupta P, Chadaram S, Sharma V, Soni K, Choudhury B, Goyal A. Skull base defects: outcomes and reconstruction from a tertiary center in India. Arch Craniofac Surg 2025;26(6):225-234. [https://doi.org/10.7181/acfs.2025.0036](https://doi.org/10.7181/acfs.2025.0036)  \n*Current affiliation: Department of ENT, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India.  \nReceived July 23, 2025 / Revised October 8, 2025 / Accepted December 3, 2025  \ncauses, including iatrogenic injuries during surgery. Pathologies requiring extensive anterior or lateral skull base resections demand complex reconstruction tailored to defect size, location, disease type, and surgical expertise [1]. Historically, open approaches were the mainstay for tumor extirpation at the skull base, though associated with significant morbidity, including cerebrospinal fluid (CSF) otorrhea/rhinorrhea, pneumocephalus, and meningitis. The importance of restoring the barrier between surgical cavities and intracranial structures led to the evolution of skull base reconstruction techniques. Endoscopic approaches, ","cbCaitG736Ignu2w","https://ap.wps.com/l/cbCaitG736Ignu2w","pdf",1972960,"English","# Background\n# Methods\n# Results\n# Conclusion\n# Abbreviations\n# Keywords","[{\"question\":\"What types of skull base defects were included in the study?\",\"answer\":\"The study included anterior and lateral skull base defects arising from both planned iatrogenic injuries and accidental intraoperative defects.\"},{\"question\":\"How were the skull base defects reconstructed?\",\"answer\":\"All patients underwent multilayered repair using combinations of autologous tissue, allogenic grafts, and vascularized flaps, with perioperative protocols including selective lumbar drainage when needed.\"},{\"question\":\"What postoperative complications were observed?\",\"answer\":\"No postoperative meningitis or recurrent CSF leaks were noted. Two major complications occurred: one case of pneumocephalus and one case of postoperative vision loss after ossifying fibroma excision.\"}]","Skull base defects - outcomes and reconstruction from a tertiary center in India | PDF",1790726563,25]